By Frieda Wiley, PharmD, BCGP, RPh
To toss or not to toss? That is the question. Whether you should toss your medications after the expiration date or keep them remains a widely debated topic. Though studies have shown some medications keep their potency far past their expiration dates, for most medications, the expiration date is there for a reason.
Here are just a few examples of situations where using expired medications might do more harm than good:
1. Some medications are more sensitive to the environment that others. Factors like temperature, sunlight, and humidity can cause many medications to break down and lose their strength. For instance, the blood thinner dabigatran (Pradaxa) is so sensitive to moisture that the manufacturer recommends you keep the medication in its original container and discard it 4 months after opening the bottle. In other words, the clock starts ticking on these capsules from the moment you open the bottle. Imagine what would happen if you took this medication 8 or 9 months after having opened the bottle? It probably wouldn’t work very well, and you could be putting yourself at risk for blood clots, stroke, or worse….
2. Some health conditions require very specific doses without a lot of wiggle room. Several examples come to mind here—one being thyroid disease. Think of your thyroid as a picky eater with a “Goldilocks syndrome”: It doesn’t like the porridge—or the medication dose— too high or too low. It likes its medication dose just right—and every single time, at that. Any dose other than what the thyroid needs can make it very unhappy and make you feel worse. Let’s say an expired bottle of thyroid medication contains 95% of the actual active ingredient instead of the full amount guaranteed if used by the expiration date. While you might not notice much of a difference in your health if your antibiotic were five percent weaker, a five percent difference in your thyroid medication might throw your thyroid—and your body—completely out of whack. This small difference could derail all your hard work to get your health back on track.
3. Some medications that are naturally more shelf-stable can become less so when mixed with other components. Let’s look at petroleum jelly. While petroleum jelly technically is not considered a drug, it is sometimes used in ointments or in compounded agents. In its pure form, petroleum jelly is waterproof and has an almost indefinite shelf life. But when you add other ingredients to it such as hydrocortisone that attract moisture, it shortens its lifespan.
The Food and Drug Administration (FDA) requires manufacturers to test their medications for stability and storage conditions. Companies use this information to figure out a date after which the medication may lose its potency. Keeping medications after their medication dates can be extremely tempting—especially when they cost so much. But to be in the clear, next time you’re wondering about whether some old medication you have laying around is still good, ask your pharmacist.
Frieda Wiley, PharmD, BCGP, RPh is a board-certified, clinical pharmacist, contract medical writer, and consultant. She has nearly 100 publications to her credit, including Arthritis Today, US News & World Report, Everyday Health, MedPage Today, and Clinical Cardiology Advisor. To read more about Frieda, visit her website, or follow her on Twitter.